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| Clinical characteristics of fulminant type 1 diabetes mellitus, acute onset type 1 diabetes and slowly progressive type 1 diabete |
| Zhong Xiaojing, Li Shunbin, Jin Yueping |
| Department of Endocrinology, Huzhou Central Hospital, Huzhou 313000, China |
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Abstract Objective To analyze the clinical features of 20 patients with acute onset type 1 diabetes (AT1DM), 11 patients with fulminant type 1 diabetes (FT1DM) and 23 patients with chronic onset type 1 diabetes (SPIDDM). Methods Data such as disease course, age, gender, body mass index, random blood glucose, HbA1c, C-peptide, creatinine, serum potassium, arterial blood pH, and white blood cell count were collected for statistical analysis, and the clinical characteristics of each subtype were further compared. Results The course of FT1DM was[(4.23±1.21)days] shorter than those of AT1DM[(146.25.±33)days] and SPIDDM[(518.2±64.6)days]. The blood glucose concentration at the onset of FT1DM[(38.23±15.41)(mmol/l)] was higher than those of AT1DM [(16.75±4.88)(mmol/l)] and SPIDDM[(13.44±4.12)(mmol/l)]. The FT1DM glycosylated hemoglobin concentration[(6.58±1.66)(mmol/l)] was lower than those of AT1DM[(12.83±3.81)(mmol/l)] and SPIDDM[(11.01±3.21)(mmol/l)]. The mean blood glucose concentration fluctuation range of FT1DM[(9.55±2.40) (mmol/l)] was higher than those of AT1DM[(5.54±1.84) (mmol/l] and SPIDDM[(5.13±1.31)(mmol/l). The difference between the maximum and minimum blood glucose concentration of FT1DM[(13.54±3.227)(mmol/l)] was higher than those of AT1DM[(7.46±3.44)(mmol/l)] and SPIDDM[(6.92±2.37)(mmol/l)]. Arterial blood pH of FT1DM (7.003±0.083) was lower than those of AT1DM (7.393±0.095) and SPIDDM (7.395±0.038). The fasting C-peptide concentration[(0.03-0.02)(ng/ml)] of FT1DM was lower than those of AT1DM[(0.91±0.43) (ng/ml)] and SPIDDM[(1.05±0. 47) (Ng/ml)]. The differences between the above indicators were statistically significant (P<0.01). Conclusion Compared with AT1DM and SPIDDM, FT1DM has a shorter duration of disease, greater fluctuations in mean blood glucose, more severe ketoacidosis, poorer islet function, and the more dangerous condition.
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Received: 28 March 2018
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